Bupropion SR and contingency management for adolescent smoking cessation

• Published in: Journal of substance abuse treatment Vol. 40; no. 1; pp. 77 - 86
• Main Authors: Gray, Kevin M., M.D, Carpenter, Matthew J., Ph.D, Baker, Nathaniel L., M.S, Hartwell, Karen J., M.D, Lewis, A. Lee, M.D, Hiott, D. Walter, M.D, Deas, Deborah, M.D., M.P.H, Upadhyaya, Himanshu P., M.B.B.S., M.S
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01-01-2011; Elsevier; Elsevier Limited
• Subjects: Abstinence; Addictive behaviors; Adolescent; Adolescents; Adult and adolescent clinical studies; Antidepressants; Behavior Therapy; Biological and medical sciences; Bupropion; Bupropion - administration & dosage; Bupropion - adverse effects; Bupropion - therapeutic use; Cessation; Child; Conditioning, Operant; Contingency learning; Contingency management; Delayed-Action Preparations; Desintoxication. Drug withdrawal; Dopamine Uptake Inhibitors - adverse effects; Dopamine Uptake Inhibitors - therapeutic use; Double-Blind Method; Drug addiction; Female; Humans; Intervention; Male; Medical sciences; Medication Adherence; Miscellaneous; Nicotine; Psychiatry; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Public health. Hygiene; Public health. Hygiene-occupational medicine; Smoking; Smoking Cessation; Substance abuse treatment; Teenagers; Tobacco; Tobacco Use Disorder - drug therapy; Treatment; Treatment Outcome; Treatments; Young Adult; Youth; Tobacco; Bupropion; Treatment; Contingency management; Adolescent; Youth; Nicotine; Smoking; Human; Drug addiction; Poison withdrawal; Psychotropic; Tobacco smoking; Alkaloid; Shutdown; Reward; Public health
• ISSN: 0740-5472; 1873-6483
• DOI: 10.1016/j.jsat.2010.08.010

Abstract There is a significant need for evidence-based treatments for adolescent smoking cessation. Prior research, although limited, has suggested potential roles for bupropion sustained-release (SR) and contingency management (CM), but no previous studies have assessed their combined effect. In a double-blind, placebo-controlled design, 134 adolescent smokers were randomized to receive a 6-week course of bupropion SR + CM, bupropion SR + non-CM, placebo + CM, or placebo + non-CM, with final follow-up at 12 weeks. The primary outcome was 7-day cotinine-verified point prevalence abstinence, allowing for a 2-week grace period. Combined bupropion SR + CM treatment yielded significantly superior abstinence rates during active treatment when compared with placebo + non-CM treatment. In addition, combined treatment showed greater efficacy at multiple time points than did either bupropion SR + non-CM or placebo + CM treatment. Combined bupropion SR and CM appears efficacious, at least in the short-term, for adolescent smoking cessation and may be superior to either intervention alone.